陈秀勤　梁乃旭

[关键词] 胃癌;胃蛋白酶原;血清;临床诊断

[中图分类号] R735.2          [文献标识码] A          [文章编号] 1673-9701（2021）17-0184-05

Research progress on the application value of serum pepsinogen detection in clinical diagnosis of early gastric cancer

CHEN Xiuqin   LIANG Naixu

Department of Medical Laboratory， Wuzhou Red Cross Hospital， Wuzhou   543002， China

[Abstract] Gastric cancer is a very common malignant tumor in clinical practice. In the entire world， gastric cancer has the second highest mortality rate among all malignant tumors. Therefore， giving gastric cancer patients a timely and accurate diagnosis in the early stage of the disease and implementing treatment interventions based on the patient's specific disease conditions is an effective way to reduce the mortality of gastric cancer patients and improve the overall quality of life. In recent years， with the continuous deepening of clinical research， the detection of serum pepsinogen （PG） has gradually attracted the attention of clinical scholars at home and abroad. Studies have pointed out that serum PG can well reflect the body's gastric mucosal state and function， and play an important role in the clinical screening of gastric cancer. This article mainly reviews the physiology of serum PG， the detection method of serum PG， the relationship between serum PG and precancerous lesions and gastric cancer， and the application of serum PG in the clinical diagnosis of gastric cancer， aiming to provide more clinical reference information and data.

[Key words] Gastric cancer; Pepsinogen; Serum; Clinical diagnosis

伴隨着临床中不断发展的相关新技术，如遗传工程学、细胞工程学、免疫学、生物化学及分子生物学等，出现了很多具有重要临床价值及意义的相关肿瘤标志物[1]。近几年以来，随着临床研究的持续深入发现，通过检测血清胃蛋白酶原（Pepsinogen，PG）水平能够对胃黏膜的状态及功能进行良好地反映，可以将其作为筛查胃癌前病变及早期胃癌高危群体的一项血清学参考指标[2]。血清PG水平改变在临床筛查胃癌高危人群中意义及血清PG浓度跟胃癌之间关系逐步成为国内外学者的一项关注研究热点及重点[3]。在胃癌癌前病变的演变规律中，机体的胃黏膜经历如下的相关改变，慢性浅表性胃炎（Chronic superficial gastritis，CSG）、萎缩性胃炎（Atrophic Gastritis，AG）、肠上皮化生（Intestinal metaplasia ，IM）、不典型增生、胃癌。本文主要对血清PG的生理、血清PG水平的检测方法、血清PG水平与癌前病变及胃癌的关系、血清PG在临床诊断胃癌中的应用情况进行一综述，现报道如下。

1 血清PG

依据不同的PG免疫学及生化特点可以将其分为两个不同的亚群：胃蛋白酶原Ⅰ（PepsinogenⅠ，PGⅠ）及胃蛋白酶原Ⅱ（PepsinogenⅡ，PGⅡ），属于门冬氨酸蛋白酶，由要由胃细胞所分泌并合成，同时还会转化成巍峨能够分解蛋白的胃蛋白酶[4]。PG I主要存在的位置为主颈黏液移行细胞、颈黏液细胞及胃底黏膜主细胞中;PGII主要存在的位置为十二指肠腺、幽门腺及胃底腺主细胞[5]。分泌的PG进入到胃腔内并遇到胃酸之后会被激活大部分，起到对蛋白质进行分解的作用[6]。……